Abstract
Rationale and objectivesThis study aimed to compare the volume computed tomography dose index (CTDIvol), dose length product (DLP), and size-specific dose estimate (SSDE), with the China and updated 2017 American College of Radiology (ACR) diagnostic reference levels (DRLs) in chest CT examinations of adults based on the water-equivalent diameter (Dw).Materials and methodsAll chest CT examinations conducted without contrast administration from January 2020 to July 2020 were retrospectively included in this study. The Dw and SSDE of all examinations were calculated automatically by “teamplay”. The CTDIvol and DLP were displayed on the DICOM-structured dose report in the console based on a 32cm phantom.The differences in patient CTDIvol, DLP, and SSDE values between groups were examined by the one-way ANOVA. The differences in patient CTDIvol, DLP, and SSDE values between the updated 2017 ACR and the China DRLs were examined with one sample t-tests.ResultsIn total 14666 chest examinations were conducted in our study. Patients were divided into four groups based on Dw:270 (1.84%) in 15–20 cm group, 10287 (70.14%) in the 21–25 cm group, 4097 (27.94%) in the 26–30 cm group, and 12 (0.08%) patients had sizes larger than 30 cm. CTDIvol, DLP, and SSDE increased as a function of Dw (p<0.05). CTDIvol was smaller than SSDE among groups (p<0.05). The mean CTDIvol and DLP values were lower than the 25th, 50th, and 75th percentile of the China DRLs (p <0.05). The CTDIvol, DLP, and SSDE were lower than the 50th and 75th percentiles of the updated 2017 ACR DRLs (p <0.05) among groups.ConclusionsSSDE takes into account the influence of the scanning parameters, patient size, and X-ray attenuation on the radiation dose, which can give a more realistic estimate of radiation exposure dose for patients undergoing CT examinations. Establishing hospital’s own DRL according to CTDIvol and SSDE is very important even though the radiation dose is lower than the national DRLs.
Highlights
Following the progress of medical examination technology and the need of medical diagnosis and treatment, computed tomography (CT) examinations have gained popularity for the diagnosis, differential diagnosis, and disease followups
size-specific dose estimate (SSDE) takes into account the influence of the scanning parameters, patient size, and X-ray attenuation on the radiation dose, which can give a more realistic estimate of radiation exposure dose for patients undergoing CT examinations
Establishing hospital’s own diagnostic reference levels (DRLs) according to CTDIvol and SSDE is very important even though the radiation dose is lower than the national DRLs
Summary
Following the progress of medical examination technology and the need of medical diagnosis and treatment, computed tomography (CT) examinations have gained popularity for the diagnosis, differential diagnosis, and disease followups. CT is by far the most important source of radiation exposure in diagnostic radiology, and the radiation dose from CT examination accounts for a large proportion of medical radiation sources [1,2,3]. Previous research has showed that 70% of the radiation doses received by patients during medical treatment were attributed to CT scans [4]. Radiation damage attributed to both deterministic and stochastic effects caused by CT radiation have been reported. An accurate estimate of the radiation dose is very important
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